A CASE OF PINEAL REGION SOL

NS III UNIT-PROF R.A.K

PRESENTATION

• 31/F

• H/O Dull aching headache-3 yrs

• No h/o seizures/vomiting

• No h/o visual disturbances

• No h/o weakness of limbs

EXAMINATION

• On examination, On examination, *conscious, *conscious, *oriented *oriented *PERL *PERL *ambulant *ambulant *Cranial nerves normal *Cranial nerves normal *V *VA , A , VVF –F –nonormal rmal *No neurological deficit *No neurological deficit

INVESTIGATIONS

• CT Brain - hypo dense lesion in posterior third ventricle-pineal region

• MRI Brain -lesion in pineal region

CT

MRI

MRI

OPTIONS – POSITION,APPROACHES

• Positions- *sitting *lateral *prone

• Approaches *Infratentorial supra cerebellar *Transcallosal interhemispheric *Occipital trans tentorial *Transcortical trans ventricular

Sitting-infratentorial supra cerebellar approach

POST OP

• Recovery good

• HPE –Epidermoid cyst